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[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

BACKGROUND: The purpose of this study is to evaluate perioperative morbidity, mortality and the prognostic factors that influence survival of the patients with transmural advanced gastric carcinoma after curative surgical therapy.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] [Early gastricadenocarcinoma].

[Transliterated title] Adénocarcinome superficiel de l'estomac.

AIM: the purpose of this study was to determine the epidemiological and clinical behaviour of the superficial adenocarcinoma of the stomach, to clarify its pathological characteristics, its therapy and prognosis.

METHODS: Over a period of 14 years (1990-2004), 16 patients were operated for a superficial gastricadenocarcinoma among 155 gastric cancers treated during the same period in the service of general surgery "A" La Rabta.

The histological diagnosis was metastasis from a primary tumour outside the oesophagus or stomach in 19 patients.

Patients in group A had definite oesophageal cancer, group B patients had a definite carcinoma located in the gastric cardia, and group C patients had an obstructing tumour distal in the oesophagus at the level of the diaphragm, which could not be passed with the endoscope.

CONCLUSION: CK phenotyping cannot distinguish between cancer arising from a Barrett's oesophagus and carcinoma originating in the gastric cardia.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Gastric cancer is a major worldwide problem and is a leading cause of death.

The incidence of distal gastric cancer is declining; however, there has been a rapid rise in the incidence of adenocarcinoma of the gastroesophageal junction, which is a more aggressive entity.

This review examines recent advances in the treatment of gastroesophageal junction adenocarcinoma and gastric cancer, newer agents and the potential agents that are in development, which can be logically applied to the treatment of this devastating disease.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

In the presented studies p53 protein expression was evaluated in samples of gastric carcinoma originating from 32 selected adult patients (with documented diagnosis of adenocarcinoma of the stomach and without the presence of Helicobacter pylori infection).

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Near-infrared Raman spectroscopy for early diagnosis and typing of adenocarcinoma in the stomach.

BACKGROUND: The aim of this study was to evaluate the feasibility of using near-infrared (NIR) Raman spectroscopy for early diagnosis and typing of intestinal and diffuse adenocarcinoma of the stomach.

One hundred gastric tissue samples from 62 patients who underwent endoscopy or gastrectomy were used (70 normal tissue specimens and 30 adenocarcinomas).

There were significant differences in Raman spectra between normal stomach and the two gastricadenocarcinoma subtypes, particularly in the spectral ranges 850-1150, 1200-1500 and 1600-1750 cm(-1), which contain signals related to proteins, nucleic acids and lipids.

[Title] [Acanthosis nigricans as the initial paraneoplastic manifestation of gastricadenocarcinoma].

Initial treatment with topical corticosteroids and oral antihistamines was unsuccessful and, due to suspicion of a paraneoplastic cutaneous syndrome, gastroscopy with sampling for biopsy and abdominal CT were carried out, revealing the existence of an infiltrating gastricadenocarcinoma and underlying adenopathies.

The present multicenter phase II study was conducted to confirm the efficacy and toxicity of DCS in advanced gastric cancer.

METHODS: Eligibility criteria included a histologically proved diagnosis ofgastricadenocarcinoma with at least one measurable metastatic lesion, no previous treatment for gastric cancer except for surgery, an ECOG performance status of 0 to 2, and adequate organ function.

CONCLUSIONS: DCS was a well-tolerated regimen with a high response rate in patients with advanced gastric cancer.

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(PMID = 27963030.001).

[ISSN] 1527-7755

[Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Paraneoplastic Guillain-Barre syndrome has been described in association with some kinds of tumors (B-cell Lymphoma and small cell lung cancer).

We describe the case of a 74-year-old woman affected by gastricadenocarcinoma, treated with surgery and adjuvant chemotherapy, who developed simultaneously skin cancer relapse and severe Guillain-Barre syndrome.

According to the poorness of data, further investigations are necessary to establish a relationship between Guillain-Barre syndrome and gastric cancer.

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[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

: e15599 Background: The role of the second line chemotherapy in advanced gastric cancer was not clear, but possibility of prolongation of survival is open question.

Irinotecan is promising agents in gastric cancer and this phase II study evaluated the efficacy and safety of combination chemotherapy with irinotecan, high dose of 5-fluorouracil (5-FU) and leucovorin in taxane and cisplatin based chemotherapy refractory metastatic gastric cancer.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

The clinicopathological characteristics of human gastric cancer and the clinical outcomes were analyzed to investigate the effects of the expression of hypoxia-inducible factor1α (HIF-1α) and some related proteins, such as, vascular endothelial growth factor (VEGF), insulin-like growth factor-2 (IGF-2), p21, and p53 on the prognosis of human gastric cancer.

METHODS: The expressions of HIF-1α, VEGF, IGF-2, p21, and p53 proteins were determined by immunohistochemistry in 216 specimens of primary gastric cancer.

In addition, the HIF-1α expression positively correlated with the tumor size and depth of invasion, while it was also more frequent in tumors with lymphatic invasion and undifferentiated adenocarcinomas.

A multivariate Cox regression analysis showed the depth of invasion, lymph node metastasis, and HIF-1α positivity to all be independent prognostic factors in patients with gastric cancer.

CONCLUSIONS: Based on the above findings, HIF-1α is therefore considered to be a useful independent prognostic factor in gastric cancer, and the combination of a HIF-1α protein overexpression with the loss of p21 expression or nonfunctional p53 thus tends to indicate a dismal prognosis.

Controlling hypoxia, especially in the HIF-1α pathways, may therefore hold the key to a greater individualization of therapy and also lead to the development of new treatments for patients with gastric cancer.

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(PMID = 27963078.001).

[ISSN] 1527-7755

[Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology

: 4538 Background: Patients (pts.) suffering from advanced gastric cancer have still a poor prognosis and treatment options are limited.

In our previous phase II trial (AGMT-Gastric-1) we could show that the combination of oxaliplatin and irinotecan was well tolerated and showed an objective response rate of 58% (Anticancer Res 28:2901-2906, 2008).

51 patients with histological proven unresectable and/or metastatic gastricadenocarcinoma were treated in a first line setting.

CONCLUSIONS: The combination of oxaliplatin and irinotecan with cetuximab is feasible, safe and active in advanced gastric cancer.

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(PMID = 27962987.001).

[ISSN] 1527-7755

[Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

: 4537 Background: Although the adjuvant chemoradiation therapy has gained popularity and has become the standard of care in patients with resected gastric cancer in U.S., the role of chemoradiation therapy after extended D2 dissection has been questioned.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

: e15638 Background: The present study analyzed the functional insertion/deletion polymorphism in the promoter region of NKFB1 gene and their impact on the prognosis for patients with gastricadenocarcinoma.

METHODS: Five hundred and three consecutive patients with surgically resected gastricadenocarcinoma were enrolled in the present study.

The multivariate survival analysis showed no association between the NFKB1 -94 insertion/deletion promoter polymorphism and the disease-free survival or overall survival of the patients with gastric cancer.

CONCLUSIONS: The functional NFKB1 promoter polymorphism was not found to be a prognostic marker for Korean patients with surgically resected gastricadenocarcinoma.

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(PMID = 27962749.001).

[ISSN] 1527-7755

[Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

: 4534 Background: Cetuximab has demonstrated high efficacy in combination with irinotecan-based therapies in metastatic colorectal cancer and irinotecan/folinic acid/5-FU (IF) may be an effective alternative to cisplatin-based regimens in advanced gastric cancer.

We therefore conducted a phase II AIO study to evaluate the tolerability and efficacy of cetuximab combined with IF as first-line treatment in patients with advanced gastric cancer.

RESULTS: Between Aug 2006 and Sep 2007, 49 pts were enrolled: 71% were males, median age was 63 years (range 33-77), median PS was 0 (65% pts), and 69% of pts and 31% of pts had gastric and oesophagogastric junction carcinomas, respectively.

Cetuximab combined with chemotherapy in advanced or metastatic gastric cancer is under further investigation in an ongoing phase III trial.

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(PMID = 27962992.001).

[ISSN] 1527-7755

[Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology

: e22218 Background: Hereditary Diffuse Gastric Cancer (HDGC) syndrome is characterized by the predisposition to gastric cancer of the diffuse type and to breast cancer of the lobular type.

The median age of onset for diffuse gastric cancer is 38 years.

RESULTS: A pathogenic mutation located on exon 7 of the CDH1 gene was identified in a female patient diagnosed with bilateral breast cancer at the age of 36.

She underwent bilateral mastectomy for an infiltrating ductal adenocarcinoma of the left breast and in situ lobular of the right breast.

At the age of 45 the patient underwent gastrectomy for diffuse type gastricadenocarcinoma.

She had a positive family history for breast and gastric cancer from both sides, but without meeting the absolute clinical criteria for hereditary diffuse gastric cancer syndrome.

The nonsense mutation found was probably maternally inherited, since the maternal grandmother was diagnosed with breast cancer at the age of 38.

CONCLUSIONS: The selection process of patients for genetic testing for the HDGC syndrome is not quite clear at the moment, as it is apparent that more types of breast cancer and not only lobular, can be associated with the syndrome.

Criteria should be more flexible in respects to the histopathology of the cancer type.

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(PMID = 27964173.001).

[ISSN] 1527-7755

[Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology

[Publication-type] Journal Article

[Publication-country] United States

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] p53 and its influence in adenocarcinoma stomach.

: e15685 Background: Gastric cancer is the second most common cause of the malignancy in the world after lung cancer.

Various pathogenesis have been given for the adenocarcinoma, like mutation in the E-catherin gene, amplification of COX-2, HGF/ SF, VEGF; deletion of FHIT, APC, p53 but none have provided a definite target for treatment.

METHODS: This is a immunohistochemical prospective experiment study done on 76 cases of GastricAdenocarcinoma.The location of the tumors were recorded as in the proximal stomach (fundus and body) and distal stomach (antrum, prepylorus, and pylorus).

33 out of 60 (55%)of the males and 8 out of 16 (50%) females were reported of having gastricadenocarcinoma with p53expression.

The histology of the tissue samples from the gastricadenocarcinoma patients had following relationship with the p53 immunoreactivity, 20 out of 37 cases(54.05%) of the well differentiated,7 out of 17 cases (41.18% )of the moderately differentiated, and and 13 out of 21 cases(61.90%) of the poorly differentiated gastricadenocarcinoma showed positive immunoreactivity.

15 out of 33 cases (45.45%)were localized to the proximal stomach and 30 out of 52 cases (57.69%)were localized to the distal stomach.

The purpose of this study was to analyze the natural history of stage IV gastric cancer with sequential CTx Methods: A total of 532 patients (pts) with unresectable gastricadenocarcinoma were studied.

CONCLUSIONS: When pts with unresectable gastric cancer were managed with a strategy of maximal administration of CTx, a considerable number of pts could receive 2<sup>nd</sup> or 3<sup>rd</sup> line CTx, showing modest activity.

Our data on the natural history of stage IV gastric cancer with sequential CTx may suggest that clinical trials can be performed in a 2<sup>nd</sup> or 3<sup>rd</sup> line setting as well.

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(PMID = 27962260.001).

[ISSN] 1527-7755

[Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology

[Title] A phase II study of bevacizumab, docetaxel, and oxaliplatin in gastric and GEJ cancer.

METHODS: The primary endpoint was time to progression (TTP) in patients with locally advanced or metastatic adenocarcinoma ofthe gastric or gastroesophageal junction treated with docetaxel, oxaliplatin and bevacizumab.

RESULTS: A total of 23 patients (median age 57, males 70%, gastric 52%) were enrolled on the study.

At this time, bevacizumab should not be used in gastric or gastroesophageal junction cancers outside of a clinical trial until its safety is well established.

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(PMID = 27963057.001).

[ISSN] 1527-7755

[Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology

A 43-year-old man had epigastric pain and was diagnosed as having gastricadenocarcinoma.

At surgery, the cystic lesion was found to be located at the lesser curvature of the stomach where the cancer invasion was seen.

The pathological diagnosis was bronchogenic cyst of the stomach involved with gastricadenocarcinoma.

Based on a similar association between gastric diffuse submucosal cysts and gastric cancer in the previous reports, it is possible that chronic inflammation from bronchogenic cysts to the gastric mucosa may cause adenocarcinoma in the stomach.

At surgery, complete combined resection without rupture of the bronchogenic cyst involved with the gastricadenocarcinoma is needed for treatment of gastric cancer to prevent dissemination of cancer cells considering when cancer cells have invaded beyond the pseudostratified ciliated columnar epithelium and within the bronchogenic cyst.

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[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

The authors review the complex biological reality of gastricadenocarcinoma from several viewpoints.

A good knowledge of this complex biological reality will allow the identification of better markers for an early diagnosis as well as vulnerable etiopathogenetic points for a useful prevention and therapy.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Hepatoid adenocarcinoma of the stomach: case report and short notes on immunohistochemical markers.

Hepatoid adenocarcinoma of the stomach is a rare type of gastric carcinoma with an extremely poor prognosis.

We describe a 72-year-old man who underwent esophagogastroduodenoscopy which revealed 50 mm exulcerated lesion with a central necrosis on the lesser curvature and the posterior wall of the body of the stomach.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Clinicopathologic features of adenocarcinoma at the gastric cardia: is it different from distal cancer of the stomach?

BACKGROUND: Although the incidence of gastric cardia cancer is considerably less than more distal gastric cancer, the rate of occurrence is now increasing.

The objective of this study was to evaluate and compare the clinicopathologic findings of gastric cardia and more distal stomach adenocarcinoma.

STUDY DESIGN: Patients included in our study were those who underwent operations for gastricadenocarcinoma in our institute from 1981 to 2006, and who had undergone complete medical history, including history of daily alcohol consumption; smoking; body mass index; and pathologic examinations.

A total of 843 patients were included in our study, and were divided into cardia and noncardia cancer groups.

RESULTS: Among the 843 patients, 23 (2.8%) had gastric cardia cancer.

Although noncardia cancer was often detected at an early stage, gastric cardia cancer was most often diagnosed at an advanced stage.

Pathologically, cardia cancer was more invasive and had more lymphatic permeation and lymph node metastasis than noncardia cancer.

CONCLUSIONS: Gastric cardia cancer occurs at a low incidence of only 2.8% of resected gastric cancers.

Unlike cases of gastric cardia cancer in Western populations, body mass index is not associated with occurrence of gastric cardia cancer in our study.

Because gastric cardia cancer appears more aggressive than noncardia gastric cancer, early diagnosis and intervention are important.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Epidemiological research has indicated that the anti-oestrogen tamoxifen, used in breast cancer therapy, may increase the risk of gastricadenocarcinoma of the intestinal but not of the diffuse type.

The study participants comprised women in the county of Stockholm who in the Swedish Cancer Register were first recorded with breast cancer and subsequently gastric cancer during the period January 1958-August 2005.

Tumour material was reviewed histologically to verify gastricadenocarcinoma diagnosis and classify these cancers into intestinal or diffuse type.

Intestinal adenocarcinomas were analysed immunohistochemically for the presence of ER alpha, beta and beta cx.

Amongst 68 women with verified gastricadenocarcinoma, 30 had been treated with tamoxifen and 38 not.

The intestinal type of gastricadenocarcinoma was not more frequent amongst tamoxifen users (27%) than amongst non-users (34%) (p=0.601).

There were no material differences between the tamoxifen groups regarding distribution of any of the three ERs of the intestinal adenocarcinoma specimens.

Tamoxifen users had a shorter latency between breast cancer and gastricadenocarcinoma (4 versus 13 years) which was similar in the intestinal and diffuse types.

This study does not support the hypothesis that tamoxifen increases the isolated risk of the intestinal type, but it indicates that tamoxifen use might accelerate the tumour progression or increase the overall risk of gastricadenocarcinoma.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

We report a case in which this hypertrichosis allowed diagnosis ofgastric cancer.

Clinical examination led to diagnosis of acquired hypertrichosis lanuginosa, which subsequently resulted in the discovery of gastricadenocarcinoma.

Our finding is original since it is the first recorded case of association with gastricadenocarcinoma.

Two hypotheses have nevertheless been suggested: acquired hypertrichosis lanuginosa could be associated with secretion by the tumour of an as yet unidentified serum factor, or with a nutritional deficiency that may accompany this form of cancer.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Extremely well differentiated adenocarcinoma of the stomach diagnosed preoperatively as esophageal achalasia: report of a case.

Extremely well differentiated primary gastricadenocarcinoma, which accounts for less than 0.2% of all gastric cancers, is associated with a better prognosis than other types of differentiated adenocarcinoma.

Among 2070 gastric carcinomas, diagnosed between 1983 and 2002 at Fukuoka University Hospital and Hamanomachi Hospital, there were three cases of primary extremely well differentiated adenocarcinoma.

We report the clinicopathological details of one case of primary gastric extremely well differentiated adenocarcinoma.

A 57-year-old man was reffered to our hospital for investigation and treatment of a gastric tumor.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] [Correlation between aneuploidy of chromosome 17, over-expression of TP53 and TOPIIalpha, and the clinicopathological features and diagnosis ofgastricadenocarcinoma].

OBJECTIVE: The purpose of this study was to investigate the markers which can be used in auxiliary diagnosis ofgastricadenocarcinoma (GAC), and their correlation with their clinicopathological features.

The centromere probe cen17, specific for chromosome 17, which was reported to be frequently amplified in GAC, was selected for the FISH analysis.

The clinicopathological features of the 99 GAC cases were reviewed, and the level of TP53 and TOPIIalpha gene expression, located in chromosome 17, was detected using tissue micro-array (TMA), compared with that of corresponding adjacent normal mucosa.

RESULTS: The statistical results of FISH and TMA showed that 58.6% of cen17 in tumor tissues were aneuploid, and 45.5% of TP53 and 84.7% of TOPIIalpha were over-expressed in GAC samples, significantly higher than those in non-tumor gastric mucosa (0, 12.1% and 14.1%, respectively) (P = 0.000).

The expression of TP53 in non-tumor gastric mucosa with dysplasia was significantly higher than that in the mucosa without dysplasia (P = 0.009).

Aneuploidy of cen17 was more frequent in grade 1 or 2 than in grade 3 GAC (P < 0.05).

Higher frequency of aneuploidy of cen17 was also observed in the gastric cardia than in pylorus (P < 0.05), while no correlation was found between aneuploidy of cen17 and age, sex of patients, lymph node metastasis, and clinical stage of tumors.

CONCLUSION: Detection of aneuploidy of cen17 as well as over-expression of TP53 and TOPIIalpha may be helpful in the diagnosis and prognostic prediction of gastricadenocarcinoma.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Alpha-fetoprotein (AFP)- and des-gamma-carboxy prothrombin (DCP)-producing adenocarcinoma of the stomach with liver metastasis in a patient with chronic hepatitis C.

A 45-year-old man was admitted to our hospital because of chronic hepatitis C and a large liver tumor accompanied by increased serum levels of alpha-fetoprotein (AFP) and des-gamma-carboxy prothrombin (DCP), the tumor markers for hepatocellular carcinoma.

Endoscopic examination revealed advanced gastric cancer.

Biopsy specimens of the stomach and liver showed gastricadenocarcinoma and its metastasis to the liver.

Immunohistochemical studies demonstrated that adenocarcinoma cells both of the stomach and liver, were positive for the antibodies against AFP as well as DCP.

Expression of AFP mRNA was shown in the cancer cells of the stomach.

Accordingly, we diagnosed this patient with AFP- and DCP-producing adenocarcinoma of the stomach together with liver metastasis.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Chemoprevention in gastrointestinal adenocarcinoma: for few but not for all?

Despite the general progress of the last two decades in oncogenesis mechanism comprehension, in screening and surveillance programs, in technological support to diagnosis and in treatment protocols, the long-term survival of gastrointestinal (GI) cancer patients is not substantially changed.

Therefore chemoprevention strategies still appear as a possible alternative to screening and surveillance programs in reducing the incidence and the mortality for GI cancer, at an acceptable cost/effectiveness ratio.

The present review is focused on three GI cancers: esophageal adenocarcinoma, gastric cancer and colorectal cancer and their respective precarcinogenic lesions.

The authors examine, for each neoplasia, the available chemopreventive agents, their mechanism of action in preventing cancer, the potential targets in the cell growth process, the cost/effectiveness ratio and, whenever present in literature, a comparison with other cancer prevention strategies.

The authors conclude that, at present, with the available agents, chemoprevention is not indicated for all patients at low or moderate risk for GI cancer, and should not be considered as a substitute for endoscopic surveillance.

In future more specific agents and combined therapies should be tested in specific group of patients identified by their genomic susceptibility to develop cancer and responsiveness to therapy.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] AFP-producing hepatoid adenocarcinoma of the stomach: a case report.

Hepatoid gastricadenocarcinoma is a distinct variant of gastric carcinoma which represents a comparatively small percentage of the disease and in many cases is producing high serum alpha-fetoprotein (AFP).

We report a case of an 85 year old woman who presented with epigastric and right upper quadrant pain and was found in a CT scan to have multiple liver nodules and a gastric antrum mass as well as an elevated AFP level of 155000 IU/ml.

An endoscopic biopsy of the antral mass showed hepatoid variant of gastricadenocarcinoma.

The patient refused any further treatment and died 4 months after diagnosis.

Hepatoid gastricadenocarcinoma is considered to have a poor prognosis, although cases with survival of several years have been reported.

Poor outcome in most of the cases is due to the fact that, as in our patient, metastatic disease is already present at diagnosis.

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CONCLUSION: The experimental design presented in the study may be of potential value for clinicians: at least five relevant markers for both MSI and LOH analysis may be needed to evaluate a gastric cancer (GC) patient's clinical status.

For this reason, we investigate histopathological and immunohistochemically 77 cases of upper gastric pole adenocarcinoma selected from a number of 472 gastric tumors.

Nevertheless, we pointed out the predominance of diffuse adenocarcinomas type according to Laurens classification, which immunohistochemically were strong positive to cytokeratins, EMA, CEA and lysozyme.

Linitis plastica is a malignant disease that usually occurs in the stomach, although it can affect any segment of the alimentary tract.

We present the case of a patient with a previous diagnosis of signet ring cell cancer of the stomach that had been treated with curative intent 12 years before the clinical onset of small and large bowel linitis plastica.

The diagnosis was obtained as an incidental pathological finding after urgent surgery for intestinal obstruction.

No gastric mass was found.

Linitis plastica should be considered in the differential diagnosis of patients with symptoms of obstruction after resection of a gastric carcinoma, especially if there are macroscopic surgical findings of circumferential narrowing.

A long interval after diagnosis and treatment of the primary disease does not allow malignancy to be ruled out.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

The prognosis of locally advanced gastric cancer remains poor.

Two randomized studies that have been performed in Europe have shown that peri-operative chemotherapy significantly improves the survival of patients with adenocarcinoma of the stomach and of the gastro-esophageal junction.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Shrinkage of gastric cancer in an elderly patient who received Rhus verniciflua Stokes extract.

PATIENT AND METHOD: We present here the case of a female patient (82 years old) with an adenocarcinoma of the stomach that was first diagnosed via an abdomen computed tomography (CT) scan and endoscopic biopsy.

CONCLUSIONS: We suggest that RVS extract could be a candidate for a natural agent that induces selective apoptosis and inhibits cell growth in gastricadenocarcinoma.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Evidence for hepatocellular differentiation in alpha-fetoprotein-negative gastricadenocarcinoma with hepatoid morphology: a study with in situ hybridisation for albumin mRNA.

AIM: Hepatoid adenocarcinoma, a putative chemosensitive tumour, is defined as a tumour with aberrant hepatocellular differentiation occurring in extrahepatic organs such as the stomach, usually in the gastrointestinal tract.

We investigated ALB mRNA to address whether adenocarcinoma with hepatoid morphology, regardless of AFP production, can be diagnosed solely by morphological criteria as a hepatoid adenocarcinoma.

METHODS: We performed in situ hybridisation (ISH) and immunohistochemistry (IH) for ALB mRNA on AFP-negative gastric adenocarcinomas with hepatoid morphology.

RESULTS: All three gastric adenocarcinomas with hepatoid morphology with no evidence of AFP production stained positive for ALB mRNA, thus providing evidence of differentiation in the hepatocellular direction.

Three of five cases of AFP-positive hepatoid adenocarcinoma of the stomach were positive for ALB mRNA, while 11 cases of AFP-negative conventional gastricadenocarcinoma were negative.

CONCLUSION: The present study demonstrates that, irrespective of AFP production, gastricadenocarcinoma with morphological patterns suggestive of hepatoid differentiation should be diagnosed as hepatoid adenocarcinoma with important prognostic implications.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Evaluation of the toxicity of the combined treatment of chemoradiotherapy, according to the scheme of Macdonald, after radical surgery in patients diagnosed of gastric cancer.

PURPOSE: In this study we evaluated the acute toxicity of the combined treatment with chemoradiotherapy, according to the scheme of McDonald et al, in patients diagnosed with gastric cancer, after radical curative surgery.

METHODS: From July 2001 to December 2005, a total of 24 patients, with diagnosis of adenocarcinoma of the stomach or adenocarcinoma of the gastroesophageal junction, who were operated with total or subtotal gastrectomy with free resection margins, were treated at our service with a combined scheme of adjuvant chemoradiotherapy.

CONCLUSIONS: Combined treatment with chemoradiotherapy, according to the scheme of Macdonald, in diagnosed patients with gastric cancer, after radical curative surgery is a well tolerated treatment, with a low degree of acute toxicity, thus the treatment compliance is not difficult.

[MeSH-major]Adenocarcinoma / therapy. Stomach Neoplasms / therapy

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[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Differentiated adenocarcinoma of the stomach is classified into gastric or intestinal phenotypes based on mucus expression.

Recent advances in mucin histochemistry and immunohistochemistry have highlighted the importance of such a distinction, and it is important clinically to distinguish between gastric- and intestinal-type differentiated adenocarcinoma.

However, a clinical and pathological diagnosis of this type is often difficult in early gastric cancer because of histological similarities between a hyperplastic epithelium and low-grade atypia.

It is therefore critical to consider these diagnostic difficulties and different biological behaviors with high malignant potential when treating patients with gastric-type differentiated adenocarcinoma.

[MeSH-major]Adenocarcinoma. Mucins. Phenotype. Stomach Neoplasms

[MeSH-minor]Diagnosis, Differential. Humans

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[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Interaction of microsatellite instability and loss of heterozygosity in adenocarcinoma: multiple markers in adenocarcinoma: an introduction to 'Genetic changes in Slovenian patients with gastricadenocarcinoma evaluated in terms of microsatellite DNA'.

Gastric cancer is the second most frequent cause of cancer death worldwide, yet the precise mechanisms underlying the different subtypes of gastric carcinogenesis are poorly understood.

Improvements in the diagnosis and prognosis of gastric cancer over classical clinicopathologic findings such as TNM stage, age or macroscopic tumor type, now include novel techniques for superficial endoscopic examination, and new strategies for genetically analyzing biopsied specimens.

The development of gastric adenocarcinomas, such as that of many tumor classes, represents the cumulative effects of several different types of mutations, and it is now recognized that both the loss of normal DNA repair, as well as the mutation, loss or inhibition of tumor suppressor genes contribute to the genetic instability leading to cancer.

It might be logically anticipated that the combined burden of these two defects would synergize in carcinogenesis, but the extent to which such pathways cooperate in promoting cancer is still not yet well understood.

Clearly, an enhanced appreciation of the mechanisms and interactions of these pathways would aid development of diagnosis and treatment options.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Superoxide dismutase in gastricadenocarcinoma: is it a clinical biomarker in the development of cancer?

Gastric cancer is the second most common cancer worldwide.

The involvement of reactive oxygen species (ROS) in the pathogenesis of gastric malignancies is well known.

The aim of this study is the detection of MnSOD and CuZnSOD activity and their expression in gastricadenocarcinoma and healthy tissues.

Gastric samples (adenocarcinoma and healthy tissues) harvested during endoscopy or resected during surgery were used to determine MnSOD and CuZnSOD activity and expression by spectrophotometric and Western blotting assays.

The total SOD activity was significantly higher (p<0.05) in healthy mucosa with respect to gastric adenocarcinomas.

No differences were found in MnSOD activity and, on the contrary, CuZnSOD activity was significantly lower (p<0.001) in cancer samples with respect to normal mucosa.

The rate of MnSOD/CuZnSOD activity in adenocarcinoma was over ninefold higher than that registered in healthy tissues (p<0.05).

Moreover, in adenocarcinoma MnSOD activity represented the 83% of total SOD with respect to healthy tissues where the ratio was 52% (p<0.001).

On the contrary, in cancer tissues, CuZnSOD activity accounted for only 17% of the total SOD (p<0.001 if compared with the values recorded in normal mucosa).

After immunoblotting, MnSOD was more expressed in adenocarcinoma with respect to normal mucosa (p<0.001), while CuZnSOD was similarly expressed in adenocarcinoma and healthy tissues.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Cerebral metastasis from hepatoid adenocarcinoma of the stomach.

We first report a rare case of metastasis from gastric hepatoid adenocarcinoma (HAC) to cerebral parenchyma, in a 50-year-old Chinese patient.

Three years ago, the patient accepted total gastrectomy as he was pathologically diagnosed at gastroscopy having an adenocarcinoma.

Histopathological characteristics of the brain tumor were identical to those of stomach tumor.

The differential diagnosis of brain metastasis from metastatic tumors should use a panel of antibodies to avoid confusing with the brain metastasis of hepatocellular carcinoma (HCC).

This paper describes this rare case of metastasis from gastric hepatoid adenocarcinoma to cerebral parenchyma, and provides a review of the literature concerning its histopathological and immunohistochemical characteristics.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

AIM: Minimal deviation carcinoma of the uterine cervix, otherwise known as extremely well-differentiated adenocarcinoma (EWDA), is characterized by its benign microscopic appearance in contrast to its aggressive behavior.

In order to elucidate the clinicopathological features and biological behavior of the gastric counterpart of EWDA, we, using immunohistochemistry, analyzed nine lesions for the phenotypic expression, proliferative activity, and the expression of oncogene-associated products.

Using immunohistochemistry, Ki-67 labeling index and expression of p53 and c-erbB-2 protein in the gastric lesions were detected.

RESULT: Locations in the middle or upper third of the stomach and polypoid macroscopic features are characteristic of EWDA of the stomach.

All 9 cases of EWDA could be classified into gastric phenotype (5 lesions) and intestinal phenotype (4 lesions).

The former resembled gastric foveolar epithelium, mucous neck cells or pyloric glands, but their papillary structures were frequently elongated and the tumor cells and their nuclei were slightly larger and more hyperchromatic compared to normal epithelium.

CONCLUSION: Unlike minimal deviation carcinoma of the cervix, these findings suggest that EWDA of the stomach is a lesion of low-grade malignancy.

Because of its resemblance to normal gastric mucosa or mucosa with intestinal metaplasia, EWDA is often misdiagnosed.

Moreover, the subsequent endoscopy revealed gastric tumor.

However, the tumor histology of the stomach and liver revealed glandular adenocarcinoma with hepatoid foci.

The final diagnosis is hepatoid adenocarcinoma of the stomach with liver metastasis.

CONCLUSION: Hepatoid adenocarcinoma is an aggressive tumor with liver metastasis being the first clinical manifestation of the neoplasm.

Hepatoid adenocarcinoma of the stomach with liver metastasis should be considered in older patients with elevated serum alpha-fetoprotein and multiple hepatic tumors with underlying chronic liver disease.

An upper gastrointestinal endoscopy should be performed to exclude the possibility of hepatoid adenocarcinoma originating from the stomach to avoid potential misdiagnosis and inappropriate therapy.

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[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Gene expression profiling with microarray and SAGE identifies PLUNC as a marker for hepatoid adenocarcinoma of the stomach.

Gastric cancer is one of the most common malignancies worldwide.

In this study, we screened for genes upregulated in gastric cancer by comparing gene expression profiles from serial analysis of gene expression and microarray and identified the palate, lung, and nasal epithelium carcinoma-associated protein (PLUNC) gene.

To investigate the utility of PLUNC immunostaining in the diagnosis ofgastric hepatoid adenocarcinoma, six cases of gastric hepatoid adenocarcinoma (six primary tumors and two associated liver metastases) were studied further.

PLUNC staining was observed in all six primary hepatoid adenocarcinomas.

PLUNC staining was observed in both the hepatoid adenocarcinoma and tubular/papillary adenocarcinoma components of primary tumors, although PLUNC staining was preferentially localized in tubular/papillary adenocarcinoma components.

These results indicate that PLUNC is a novel marker that distinguishes gastric hepatoid adenocarcinoma from primary hepatocellular carcinoma.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Neoplastic meningitis as the presenting manifestation of gastricadenocarcinoma.

The aetiology of the chronic meningitis was revealed gastric cancer by gastroscopy, and micrometastasis by bone marrow trephine biopsy.

Autopsy confirmed the presence of advanced gastric cancer (adenocarcinoma of signet-ring cell type) with pancreatic involvement, and NM with cancer cells on the meninges, but without infiltration tumour cells into underlying brain parenchyma.

We conclude that NM as an initial symptom of gastric cancer is rare and ultimately fatal.

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[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Exophytic adenocarcinoma of the stomach: computed tomography and ultrasonography features with emphasis on differentiation from a malignant gastrointestinal stromal tumor.

The purpose of this study was to assess the computed tomography (CT) and ultrasonography (US) findings from cases of exophytic adenocarcinoma of the stomach (EAS) and to determine their value in distinguishing between an EAS and a malignant gastrointestinal stromal tumor (MST).

Antral location, thickening of the gastric wall adjacent to an exogastric mass, lymph node enlargement, and discordant images between US and CT are typical of EAS cases and allow distinction between cases of EAS and MST.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Interrelationship between MYC gene numerical aberrations and protein expression in individuals from northern Brazil with early gastricadenocarcinoma.

Gastric cancer is the second leading cause of death by cancer in Brazil.

Early gastric cancer represents approximately 10% of gastric cancer cases in some services of Brazil, which underscores the need for early gastric cancerdiagnosis that could lead to better prognosis.

There are few published studies of cytogenetic alterations in early gastric cancer.

To evaluate MYC copy number and its protein expression, we performed fluorescence in situ hybridization and immunohistochemical analyses in five early gastric adenocarcinomas in individuals from northern Brazil.

These novel findings concerning MYC copy number alteration in early gastric cancer suggest that MYC alteration is observed in the beginning of gastric carcinogenesis and could be used as a therapeutic target.

CONTEXT: The "Standards, Options and Recommendations" (SOR) project, started in 1993, is a collaboration between the Federation of French Cancer Centers (FNCLCC), the 20 French regional cancer centers, and specialists from French Public Universities, General Hospitals and Private Clinics.

The main objective is the development of clinical practice guidelines to improve the quality of health care and the outcome of cancer patients.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title]Gastricadenocarcinoma: reduction of perioperative mortality by avoidance of nontherapeutic laparotomy.

National trends indicate a longstanding decline in gastricadenocarcinoma due presumably to a decreasing prevalence of Helicobacter pylori infection.

We hypothesize that recent immigration patterns are responsible for a leveling off or even reversal of the declining incidence of gastric cancer associated with H. pylori infection.

A retrospective review of a consecutive case series at a public teaching hospital located in an area of high immigration was conducted that included all patients presenting, from 1995 through 2004, with gastricadenocarcinoma.

There was no decline in the frequency of gastricadenocarcinoma among the study population over the 10 years.

The operation rate decreased and the gastric resection rate increased from the early period to the recent period as fewer incurable advanced stage (M1) patients underwent exploratory laparotomy and were palliated by nonoperative means.

We conclude that in an area of high immigration there has been no decline in gastricadenocarcinoma rates over the past decade, and the marked reduction in perioperative mortality was due to near elimination of nontherapeutic laparotomy.

The results of immunohistochemistry confirmed that transgelin was indeed over-expressed in 22 cases of GA (22/41, 53.66%), with strong cytoplasmic staining in cancer cells of positive samples, this was absent in most paired non-neoplastic mucosa cells or gastric ulcer tissues (n = 20).

Transgelin was found over-expressed in 21 samples of cancer tissue (21/41, 51.22%) when detected by western blot.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Epigenetic inactivation of deleted in lung and esophageal cancer 1 gene by promoter methylation in gastric and colorectal adenocarcinoma.

BACKGROUND/AIM: Deleted in Lung and Esophageal Cancer 1 (DLEC1) gene was a new candidate tumor suppressor gene, we evaluated the diagnostic role of DLEC1 methylation in gastricadenocarcinoma (GAC) and colorectal adenocarcinoma (CRAC).

Moreover, 33.8% (22/65) of GAC and 39.4% (28/71) of CRAC serums had DLEC1 methylation, which was higher than that in the serums of cancer-free controls (p < 0.001), and the concordance of DLEC1 methylation in tumor tissues and corresponding serum samples was well.

CONCLUSION: Epigenetic inactivation of DLEC1 was crucial in gastric and colorectal carcinogenesis.

DLEC1 methylation in serum may be a promise biomarker for GAC and CRAC early diagnosis.

[Title] Phase II trial of docetaxel and oxaliplatin in patients with advanced gastric cancer and/or adenocarcinoma of the gastroesophageal junction.

PATIENTS AND METHODS: Patients with untreated stage IV GC or adenocarcinoma of the gastroesophageal junction (AGEJ) received docetaxel 60 mg/m(2) followed by oxaliplatin 130 mg/m(2) on day 1 of each 21-day cycle until progression or unacceptable toxicity.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Extreme aggressiveness and lethality of gastricadenocarcinoma in the very young.

OBJECTIVE: To determine whether very young patients with gastricadenocarcinoma as compared with older patients with the disease have a biologically more aggressive form of the disease, presenting at an advanced stage and conferring unusually poor perioperative and long-term outcomes.

DESIGN, SETTING, AND PATIENTS: A 15-year, single-institution, retrospective review and analysis of demographic and outcomes data for 350 patients diagnosed with gastricadenocarcinoma.

CONCLUSIONS: Very young patients (aged < or = 35 years) with gastricadenocarcinoma have significantly higher incidences of diffuse-type tumor histologic findings and both locally advanced and metastatic disease at presentation.

Strategies for earlier diagnosis together with effective new therapies are desperately needed to attenuate the extreme lethality in these uniquely unfortunate patients.